2-Year Longitudinal Analysis of the Relationships Between Violent Assault
and Substance Use in Women
Priscilla Schulz, LCSW
from an article of the same title by:
Dean G. Kilpatrick, Ron Acierno, Heidi S. Resnick, Benjamin E. Saunders,
Connie L. Best
Medical University of South Carolina
Journal of Consulting and Clinical Psychology,
V. 65 (5), 834-847, 1997
What is the purpose of this study?
Violence and substance abuse are major problems in the
lives of many U.S. women. Research reveals that compared to men, women
endure proportionately greater levels of high-severity traumatic events
and approximately 20% will experience a violent physical assault or completed
rape in their lives. Numerous authoritative studies also show a substantial
association between a history of substance abuse and a history of violent
assault among women. Within this context, the present study asks three
- Does substance use and abuse by women lead to violent
- Does assault lead to substance use problems among
- Is there a reciprocal relationship between substance
use/abuse and violent assault that places women in a vicious cycle
of victimization and substance abuse to cope with posttrauma reactio
How does the study address these questions to give
us reliable information about causality?
This study used data from the National Women's
Study. At three points over the course of two years, a randomly selected,
nationally representative sample of women in the U.S. were interviewed
by telephone regarding substance use and abuse (both alcohol use and illicit
drug use) and experiences of violent assaults including rape. Seventy-five
percent of women participants completed the longitudinal study (i.e.,
completed three telephone interviews). Collecting data on new assaults,
and new or increased substance abuse, over the course of two years allowed
researchers to explore the issue of causality by noting the temporal sequence
of events (e.g., Did substance abuse precede assault? Do women with no
substance use/abuse history begin abusing after an assault?).
What are the study's findings?
- Drug abuse increases women's risk of being assaulted.
Women drug abusers were almost twice as likely as non-abusers to be
assaulted during the study.
- The experience of assault plays a significant role
in escalating both alcohol and drug use in women, even in women who
did not have a history of alcohol or drug abuse. However, women were
more likely to turn to alcohol abuse than drug abuse after an assault.
- An assault history made women 5 times more likely
to experience a new assault during the three years of the study.
- Youth and ethnic-minority status was significantly
related to risk of being assaulted.
- Risk of new victimization was greatest in women who
used drugs and had been previously assaulted. This finding in particular
supported the idea that substance use and assault were in a vicious
cycle with one another.
What are the implications of this study?
- Screening for and treating illicit drug use in women
assault victims may reduce
their risk of future victimization besides improving their overall
mental and physical health.
- Interventions for women victims of violent assault
should not be limited to treating trauma symptoms (e.g., PTSD, anxiety,
depression), but should also address development or exacerbation of
substance abuse, in particular, alcohol abuse.
- The treatment of women substance abusers should include
screening and treatment for prior experiences of violent assault.
Reviewed by Priscilla Schulz, September 1999